Noem pushes forward on IHS accountability bill

WASHINGTON, D.C. — Rep. Kristi Noem hopes a piece of proposed legislation will serve as the first step to getting the federally operated Indian Health Service out of the hospital industry.

"As I've said before, I believe IHS should get out of the hospital business," Noem said at a legislative hearing in Washington, D.C. on Tuesday. "And my bill takes us in a step in that direction under this pilot program."

Noem spoke before the Subcommittee on Indian, Insular and Alaska Native Affairs along with representatives of the IHS, tribal boards and other organizations in reference to the Helping Ensure Accountability, Leadership, and Trust in Tribal Healthcare (HEALTTH) Act, which would address funding, accountability and employee recruitment and retention within the Great Plains region of the IHS.

During the hearing, Noem spoke of deficient care in South Dakota's IHS hospitals where providers were offering care with expired licenses, surgical implements were being washed by hand and opioids were being stolen. Noem also highlighted the conditions at the Rosebud IHS Hospital, where she said the "situation is by far the worst."

In December, the Rosebud hospital was forced to divert patients away from its emergency room due to poor reports from the Centers for Medicare and Medicaid Services (CMS), causing emergency patients to be transported approximately 50 miles away to receive care.

"In the seven months that the ER has been closed, five babies have been born in ambulances and nine people have died in transit to these other hospitals," Noem said. "So literally we're talking life and death."

Under Noem's proposal, tribal leaders would administer hospitals rather than the IHS, the agency which has failed to make effective change since deficiencies were pointed out in 2010. The proposal, which has support from tribal members including Rosebud Sioux Tribal Health board member William Bear Shield, would be the first step in guiding the tribes toward self-governance in health care.

For now, the Rosebud emergency room remains closed and Noem said she and the Rosebud Sioux Tribe have received no indication to when it will be opened again. But Noem said CMS was conducting an on-site survey on Tuesday.

Noem said she's been told for weeks that Rosebud's emergency department could open soon, and she spoke of the need to get the facility open as soon as possible.

"Every day that emergency department is closed down and services are diverted, their people are dying," Noem said. "And IHS doesn't recognize the emergency situation we have on our hands."